Commonly used painkiller poses risk of fatal heart complications. Identify if you belong to the vulnerable demographic.
In a recent study, it has been found that the use of Pregabalin, a medication commonly prescribed for chronic non-cancer pain, anxiety, and epilepsy, carries a significant risk of heart failure, particularly in older adults and those with pre-existing cardiovascular disease (CVD).
The study, which analysed data from over 246,000 Medicare patients aged 65 to 89 over a four-year period, found that Pregabalin was associated with a 48% increased risk of developing heart failure compared to another gabapentinoid, gabapentin. This risk was even higher in patients with CVD, where the risk of heart failure while on Pregabalin was 85%.
Heart failure is a condition where the heart can't pump enough blood to meet the body's needs. Symptoms of heart failure can include shortness of breath, fatigue, swelling in the legs, ankles, and feet, a persistent cough, rapid or irregular heartbeat, dizziness, and feeling lightheaded or fainting.
Pregabalin can cause side effects such as headaches, diarrhea, feeling sick, blurred vision, and memory problems. It's important to note that Pregabalin isn't suitable for some people. It's crucial to tell your doctor if you have ever had an allergic reaction to Pregabalin or any other medicine, if you have ever abused or been addicted to a medicine, if you are trying to get pregnant, already pregnant, or breastfeeding, or if you have any problems that affect your breathing.
The study also found that the increased risk of heart failure with Pregabalin was more pronounced in females, White individuals, and those with a history of cardiovascular disease. Despite the increased heart failure risk, studies did not find a significant difference in all-cause mortality between Pregabalin and gabapentin users.
The research team concluded their findings support current advice from the European Medicines Agency to exercise caution when prescribing Pregabalin to older adults with heart disease. Researchers at Columbia University Irving Medical Centre are calling for doctors to carefully consider the cardiovascular risks when prescribing Pregabalin to older or vulnerable patients.
It's worth mentioning that Pregabalin is available on prescription in the UK. However, some brands of Pregabalin liquid contain sodium, so people on a controlled sodium diet or with kidney problems should speak to their pharmacist or doctor before taking it.
In light of these findings, careful cardiovascular risk assessment is recommended before initiating Pregabalin, especially in older adults and patients with existing cardiovascular disease. For patients already on Pregabalin, clinicians should consider re-evaluating cardiovascular health to determine the continued safety of Pregabalin therapy. Given its differential risk profile, gabapentin may be preferred over Pregabalin in older adults at risk for heart failure.
Limitations of the available evidence include lack of data on ejection fraction, natriuretic peptide levels, physical activity, BMI, smoking status, and socioeconomic factors, which could influence cardiovascular risk. The data predominantly involve older, female, and White populations and may be less generalizable to other groups.
In summary, Pregabalin carries a notable increased risk of heart failure in older or vulnerable patients, especially those with existing cardiovascular disease, and should be prescribed with caution and careful cardiovascular monitoring in these populations.
- The use of Pregabalin, a medication employed for chronic non-cancer pain, anxiety, and epilepsy, is connected to a 48% increased risk of developing heart failure compared to another gabapentinoid, gabapentin, and this risk heightens in patients with pre-existing cardiovascular disease (CVD).
- Medical-health experts at Columbia University Irving Medical Centre are advocating for doctors to meticulously weigh the cardiovascular risks before prescribing Pregabalin to older or vulnerable patients, considering its significant increased risk of heart failure.
- In light of the study's findings, practising good nutrition, engaging in fitness-and-exercise, and focusing on mental-health are crucial measures to support overall health-and-wellness, especially for older adults and those with chronic-diseases.
- To ensure optimal cardiovascular-health when prescribing Pregabalin, clinicians should conduct comprehensive assessments, incorporating data on ejection fraction, natriuretic peptide levels, physical activity, BMI, smoking status, and socioeconomic factors, apart from narrowing down potential risks to older adults and patients suffering from CVD.
